Dr. Julia Steinberger is a pediatric cardiologist and Assistant Professor in Pediatrics at the University of Minnesota. The candidate's long-term goal is to develop an independent career combining clinical research with clinical medicine. The candidate is interested in the prevention of cardiovascular disease by investigating risk factors in children and adolescents and mechanisms that influence their progress to adult atherosclerotic heart disease. Her interests in this field developed during fellowship when she became interested in the relations among obesity, left ventricular mass (LVM) insulin resistance, and lipids. The proposed career development plan incorporates a multi-disciplinary program designed to provide an intense, closely mentored, patient-oriented research experience in association with a comprehensively structured didactic curriculum in epidemiology. Under the mentorship of Dr. Alan Sinaiko and Dr. David Jacobs, the candidate will investigate the effect of cardiovascular risk factors in adolescence on establishment of cardiovascular risk in young adulthood, while enrolled in a master's degree program in the Division of Epidemiology. This research will examine epidemiologic associations of body fatness, insulin resistance, lipids, and LVM and will test the hypothesis that body fatness and insulin resistance during adolescence predict levels of adiposity, insulin resistance, lipids, left ventricular mass, and systolic blood pressure in young adulthood. The study will be conducted in a cohort of 200 subjects recruited at mean age 13 years from the top 15 percent of the blood pressure distribution in a general population, and reevaluated at age 17 years. Previous studies in this cohort at age 13 have shown a difference between males and females in the response of LVM to increases in body size; and a segregation analysis in the cohort at age 17 and their parents has inferred the presence of a major gene influencing the levels of fasting insulin. Therefore, a second objective of this research will be to define gender differences in the association of left ventricular mass in young adulthood with cardiovascular risk factors in adolescence; and a third objective is to confirm the genetic results when the participants are young adults and share less of the childhood familial environment with their parents.